Download Clinical Activity Report 2015 - UVA Cardiology

Clinical Activity Report
2015
Year in Review
VOLUME AND SURGICAL OUTCOMES DATA
This report uses data compiled by The Society of
Thoracic Surgeons (STS), which collects cardiac
surgery outcomes from more than 1,000 medical
centers in the United States. The data is risk-adjusted,
reflecting the complexity of cases seen at each center.
Included is the data for the more common cardiac
surgery procedures. Often there is a relationship
between higher volumes and favorable outcomes.
TRANSPARENCY
We are transparent in our outcomes. The ratings
produced by The Society of Thoracic Surgeons (STS)
attest to both the breadth and the quality of care our
patients receive. These ratings incorporate the full
range of factors that influence outcomes and are riskadjusted, reflecting the severity of patients’ illnesses.
UVA is one of only 27 hospitals — of more than 1,000
reporting to the STS — to achieve the highest, threestar rating for both coronary artery bypass grafting
and aortic valve replacement.
Table of Contents
3 Our Commitment To Quality
18 Transplantation
6 Coronary Artery Bypass Grafting
20 Congenital Heart Surgery
9 Heart Valve Repair And Replacement
23 Complex Aortic Disease
10 Aortic Valve Surgery
26 Thoracic Surgery
12 Mitral Valve Surgery
30 Arrhythmia Surgery
14 Extracorporeal Membrane Oxygenation
31 Advancing Knowledge
16 Mechanical Circulatory Support
32 Recognition & Leadership
On behalf of the Divisions of Cardiothoracic and Vascular Surgery at the
University of Virginia Heart and Vascular Center, we are pleased to share our
latest Activity Report, outlining another year of achievements and milestones.
We hope this information will help our partnering physicians and their patients
accurately evaluate the quality of care we provide.
JOHN A. KERN, MD
Stanton P. Nolan Professor of
Thoracic and Cardiovascular Surgery
Chief, Division of Cardiothoracic Surgery
Surgical Director, Heart Transplantation/
Mechanical Circulatory Support
GILBERT R. UPCHURCH JR., MD
William Muller Professor of Surgery
Chief of Division of Vascular
and Endovascular Surgery
Director, Cardiovascular Center
of Excellence
We are grateful for the partnerships we have been forming across Virginia.
The increasing challenges and demands of healthcare delivery require us to
collaborate in ways unimaginable even a decade ago. We are proud of what
has been accomplished by our divisions and by the University of Virginia
Medical Center. However, we are keenly aware that these advances would
not be possible without the trust of our referring physicians and our patients.
The expertise of our care providers, our determination to offer the latest
advances in treatment and our focus on quality are some of the reasons for
the continued success of our programs. We have built upon a strong foundation
of innovation, groundbreaking research and a tradition of excellence. We have
strengthened our culture of collaboration, expanding our relationships within
our multidisciplinary teams and with our referring physicians. This collaboration
and teamwork have created an environment that enables the development of
innovative treatments, the introduction of state-of-the art technology and our
participation in game-changing clinical trials.
The Division of Cardiothoracic Surgery was again recognized as achieving an
overall three-star rating from the Society of Thoracic Surgeons for coronary
artery bypass grafting and aortic valve replacement. We are also proud to report
that the University of Virginia Medical Center received Magnet recognition from
the American Nurses Credentialing Center for quality patient care, excellence in
nursing care and innovative nursing practices. Approximately 7% of U.S. hospitals
have earned Magnet recognition. This award reflects the level of dedication and
expertise of our nurses and the support of the medical center leadership.
We would like to thank you for continuing to consider UVA Heart and Vascular
Center for the care of your patients. Your confidence in us and our devotion
to the treatment of each individual patient have enabled us to achieve these
outcomes. We are grateful for and honored by the opportunity to care for your
patients. We will do our best to uphold our commitment to patient safety and
to the highest standards of patient care.
Sincerely,
John A. Kern, MD
Gilbert R. Upchurch Jr., MD
1
Our Commitment to Quality
As cardiovascular and thoracic surgeons, our services
are aligned around UVA Heath System’s six goals:
■■
To become the safest place to receive care
■■
To be the healthiest work environment
■■
To provide exceptional clinical care
■■
■■
■■
o generate biomedical discovery that betters
T
the human condition
o train the healthcare workforce of the future
T
in teams
o ensure value-driven and efficient stewardship
T
of resources
■■
■■
■■
articipate in 14 registries, including The Society of
P
Thoracic Surgeons Data Registries and the Society
of Vascular Surgery’s Vascular Quality Initiative
edicate our Quality Support Teams (QSTs) to
D
continuously evaluating registry outcome data
and focusing on evidence-based improvements
for our patients
nsure our clinical teams meet regularly to
E
formulate individual care plans for each patient
— interdisciplinary partnerships that strengthen
collaboration to define and improve the care
each patient receives
To achieve these goals, we:
■■
■■
■■
articipate in daily, unit-based leadership huddles
P
and activities, which focus on safety and improving
the patient care experience, outcomes and clinical
care
emain actively involved in the Virginia Cardiac
R
Surgery Quality Initiative, the West Virginia and
Virginia Vascular Quality Initiative and the Virginias
Vascular Study Group
Integrate clinical research programs into practice,
which allows us to bring novel therapies to patients
UVA was recognized among the top 3% of hospitals
nationally that achieved an overall prestigious
three-star rating — the highest available — from
The Society of Thoracic Surgeons (STS) for both
isolated coronary artery bypass grafting (CABG)
and aortic valve replacement (AVR) surgeries. The
rating is awarded to hospitals that demonstrate the
highest quality in cardiac surgery.
Source: 2014 STS National Adult Cardiac Surgery Database Report
Adult Cardiovascular Surgery team (left-right): Curtis Tribble, MD; Gorav Ailawadi, MD; John Kern, MD;
Irving Kron, MD; Ravi Ghanta, MD; and Leora Yarboro, MD.
3
Our Commitment to Quality (continued)
Volume Distribution | 2014
COMPLEX PATIENTS, COMPLEX CARE
STRONG RELATIONSHIPS
We offer our patients:
(Includes Peds
Congenital)
UVA is one of the original three founding
hospitals
of
the Virginia Cardiac Surgery Quality
Initiative (VCSQI),
Vascular Surgery
(Includes Outpatient
a voluntary consortium of 18 hospitals
and 14 cardiac
PVI Procedures)
surgical practices in Virginia, founded in 1996. VCSQI
Thoracic Surgery
members:
■■
■■
■■
■■
■■
Access to the latest clinical trials
esources of regional and national leaders in
R
reoperative and complex surgery
ull-spectrum care, including minimally invasive
F
surgeries, catheter-based techniques, hybrid
procedures and robotics
ecognized clinical expertise in percutaneous
R
heart valve and hybrid vascular procedures, as
well as advanced heart failure therapies such
as left ventricular assist devices (LVADs)
Dedicated multidisciplinary teams
DEDICATED TEAMS
Our Cardiac Anesthesiology and Intensivist teams staff
the Thoracic Cardio Vascular Intensive Care Unit and
manage cardiovascular and thoracic operating rooms
and hybrid ORs. These experts have:
■■
■■
dvanced fellowship training in cardiothoracic
A
anesthesiology and critical care
pecialized training in intraoperative
S
transesophageal echocardiogram, single-lung
ventilation, advanced hemodynamic monitoring
and invasive monitoring techniques
■■
Cardiac Surgery
Exchange information to improve the quality of care
Source: UVA Heart and Vascular Center Quality Office
■■
■■
■■
evelop and implement protocols to reduce
D
complications
dopted quality measures in cardiac surgery for the
A
National Quality Forum (NQF)
ormulated policies on pay-for-performance
F
programs
Cardiac Surgery Procedures | 2012–2014
(n = 3,009)
500
400
300
200
100
0
CY 2012
CY 2013
CY 2014
CABG Only
All Valves
VADS and Transplants
Thoracic Aortic Repair
Other
Pediatric Congenital
Source: Heart and Vascular Center Quality Office
Isolated CABG Operative Mortality
Volume Distribution | 2014
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
Cardiac Surgery
(Includes Peds Congenital)
3.0%
Vascular Surgery
(Includes Outpatient
PVI Procedures)
Major Procedures Operative Mortality
Thoracic Surgery
3.0%
Source: UVA Heart and Vascular Center Quality Office
2.0%
Comparison of UVA’s
Risk-Adjusted Operative Mortality to STS Mean*
2.0%
1.0%
0.0%
2012
1.0%
2013
UVA Risk-Adjusted Operative Mortality
STS Risk-Adjusted Operative Mortality
4
0.0%
Source: 2014 STS National Adult Cardiac Surgery Database Report
2012
2013
2014
2014
Cardiac Surgery Procedures | 2012–2014
EXPRESSION OF GRATITUDE
“From the time I first contacted the Heart &
Vascular Center, I felt as though I was dealing
with people who cared about me as a person —
not just [as} another patient.”
(n = 3,009)
QUALITY OUTCOMES
Our team is committed to continuing to improve our
outcomes. Our dedication is reflected in achieving
400
three-star ratings from the STS for two years in a row
300
for isolated CABG and isolated AVR.
500
200
100
UVA exceeds NQF benchmarks for three-year
0
outcomes
with the
following:
CYassociated
2012
CY 2013
CY 2014
■■
CABG
All Valves
AVR
andOnly
CABG operative mortality
■■
Mitral valve repair (MVR) operative mortality
THE O/E MORTALITY RATIO
The observed to expected (O/E) risk-adjusted
mortality (death) rate measures how we are
performing in relation to what is expected given
our patient population. The O/E takes into
account how sick the patients are before surgery.
■■
■■
low O/E ratio indicates a better-thanA
expected outcome and a high O/E ratio
indicates a poorer-than-expected outcome.
ratio of less than 1.0 means that fewer
A
patients died than expected based on the
performance of other hospitals, as adjusted
for patients with the same types and severity
of medical problems.
The Cardiac Surgery STS report provides reports
on “Like Group” and the STS national average.
“Like Group” refers to hospitals similar to UVA in
respect to annual case volume and presence or
absence of a surgical residency program.
VADS and Transplants
Thoracic Aortic Repair
Other
Pediatric Congenital
Source: Heart and Vascular Center Quality Office
MAJOR PROCEDURES
STS defines major procedures to include isolated CABG,
valve, and combined valve and CABG procedures.
Major Procedures Operative Mortality
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
3.0%
2.0%
1.0%
0.0%
2012
2013
2014
UVA Risk-Adjusted Operative Mortality
STS Risk-Adjusted Operative Mortality
*Comparison of STS mean is all STS Hospitals
Source: 2014 STS National Adult Cardiac Surgery Database Report
Risk-Adjusted O/E | 2014
UVA
LIKE
GROUP
STS
Operative Mortality
0.64
0.79
1.0
In-Hospital Mortality
0.55
0.81
1.0
Source: 2014 STS National Adult Cardiac Surgery Database Report
5
Coronary Artery Bypass Grafting
UVA surgeons performed 756 isolated coronary
artery bypass grafting (CABG) procedures over the
past three years.
Isolated CABG Operative Mortality
EXCEEDING STANDARDS
UVA Heart and Vascular Center exceeds National
Quality Forum (NQF) standards for isolated CABG.
These standards include:
■■
AVR/CABG Operative Mortality
Preoperative beta-blockers
■■
Use of internal mammary arteries
■■
Postoperative medications
■■
Operative mortality
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
3.0%
2.0%
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
5.0%
4.0%
3.0%
1.0%
0.0%
2012
2013
2014
UVA Risk-Adjusted Operative Mortality
STS Risk-Adjusted Operative Mortality
Source: 2014 STS National Adult Cardiac Surgery Database Report
2.0%
Our patients have
a higher-than-average incidence
of co-morbidities
such as diabetes, congestive heart
1.0%
failure, arrhythmia, prior myocardial infarction, low
0.0%
ejection fraction of <40%, chronic lung disease,
2012
2013
cerebral vascular disease and peripheral artery
UVA patient
Risk-Adjusted
Operative Mortality
disease. Despite our high-risk
populations,
STS Risk-Adjusted Operative Mortality
our risk-adjusted mortality is less than expected,
*STS for
meanboth
is all STS
Hospitals
with a rate of 0.7%
in-hospital
and operative
Source: 2014 STS National Adult Cardiac Surgery Database Report
mortality in 2014.
Based on data comparisons from January 2014 through December
2014. National comparison 1.7%. Source: STS National Reports
OBSERVED/EXPECTED (O/E)
In-hospital and operative mortality risk-adjusted rates
remain below the national benchmark set by the STS.
(n=1263)
Valve Procedures | 2012–2014
TAVR/Mitral Clips | 2012–2014
UVA exceeds national standards for major
complications in120
isolated CABG patients.
500
Isolated CABG Risk-Adjusted O/E | 2014
400
100
Isolated CABG Risk-Adjusted Complications | 2014
U VA
LIKE
GROUP
STS
80
300
Operative Mortality
0.34
0.85
1.0
60
In-Hospital Mortality
200
0.42
0.92
1.0
Major Complications
100
or Op Mortality
0.83
0.95
1.0
0 2014 STS National Adult Cardiac Surgery Database Report
Source:
CY 2012
CY 2013
CY 2014
AVR
MVR
Multi-Valve
Other
U VA
STS
Prolonged Ventilation
6.5%
8.2%
Renal Failure
40
1.6%
2.0%
Permanent Stroke
20
1.2%
1.3%
2.6%
3.5%
Any Reoperations
0
Deep Sternal Wounds
CY 2012
CY 2013 0.3%
0.3%
Source: 2014 STS National Adult Cardiac
Report
TAVRsSurgery Database
Mitral Clips
Source: UVA Heart and Vascular Center Quality Office
Source: UVA Heart and Vascular Center Quality Office
Isolated AVR Operative Mortality
Minimally Invasive Valve Surgery
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
60
3.0%
6
2.0%
2014
50
40
CY 2014
John Kern, MD, Cardiothoracic and Vascularand Adult Cardiac Transplant Surgeon.
John Kern, MD, Cardiothoracic and Vascularand Adult Cardiac Transplant Surgeon.
UVA is among the 9.4% of hospitals nationally that
CLINICAL TRIAL HIGHLIGHTS
achieved an overall three-star rating — the highest
■■
possible — from The Society of Thoracic Surgeons
(STS) for isolated coronary artery bypass grafting
surgery.
Based on data comparisons from January 2014 through December 2014.
Source: 2014 STS National Adult Cardiac Surgery Database Report
■■
AME 3, a multicenter, worldwide, prospective
F
randomized trial designed evaluate FFR-guided
PCI with the second-generation Resolute™ DES
vs. CABG in patients with multivessel coronary
artery disease
YBRID REVASCULARIZATION, a completed
H
observational study in hybrid coronary
revascularization using minimally invasive CABG
avoiding stenting and cadiopulmonary bypass
7
Gorav Ailawadi, MD, Adult Cardiovascular and Cardiac Transplant Surgeon.
EXPRESSION OF GRATITUDE
“Meeting the UVA team is what sealed the deal.
They were very human, they were very kind,
they listened and — best of all — they explained.
You are truly treated as an individual, with your
particular needs being considered.”
8
Heart Valve Repair and Replacement
In 2014, UVA surgeons performed 427 total valve
Isolated CABG
Mortality
surgeries.
UVAOperative
offers a full
range of treatment
Comparison
of
UVA’s
Risk-Adjusted
Operative
Mortality to STS Mean*
options for valve patients, including:
■■
raditional open repair and replacement procedures
T
for all valves
3.0%
■■
inimally invasive surgical repair and replacement
M
program for aortic, mitral and tricuspid valves
PRIOR CARDIAC SURGERY
AVR/CABG
UVA performs complex
and Operative
reoperativeMortality
surgery, which
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean
contributes to the complexity of our patient cases.
5.0%
Patients Who Have Undergone
Previous Cardiac4.0%
Surgery | 2014
2.0%
High
1.0%
■■
proportion of complex reoperations
ercutaneous options, including transcatheter aortic
P
valve replacements (TAVR) through clinical trials and
0.0%
2012 devices
2013
2014
FDA-approved
■■
■■
UVA Risk-Adjusted
Operative
Mortality
ercutaneous
P
mitral repair
(MitraClip®
®) and
STS
Risk-Adjusted
Operative
Mortality
pulmonary valve implantation
3.0%
pcoming: Transcatheter valve replacement
U
and tricuspid valve repair
STS
Isolated AVR
2.0%
23.6%
14.6%
AVR/CABG
1.0%
11.4%
8.0%
37.9%
30.8%
MV Replacement
0.0%
MV Replacement/CABG
2012
MVR Repair
20.0%2013 12.0%
8.9%
2014
7.3%
UVA Risk-Adjusted Operative Mortality
STS Risk-Adjusted
Operative Mortality
Source: 2014 STS National Adult Cardiac Surgery
Database Report
*STS mean is all STS Hospitals
Source: 2014 STS National Adult Cardiac Surgery Database Report
Source: 2014 STS National Adult Cardiac Surgery Database Report
■■
U VA
CLINICAL TRIAL HIGHLIGHTS
(n=1263)
We are active in clinical research for valve disease. We
are participating in multiple trials for traditional valve
TAVR/Mitral Clips | 2012–2014
replacement, transcatheter valve and neuroprotection.
500
Open valve replacement trials:
Valve Procedures | 2012–2014
120
100
■■
400
300
■■
200
orin Mitroflow™ Aortic Valve trial
S
John Kern, MD,80National Principal Investigator
60 trial – Sutureless aortic valve
Sorin Perceval™
40
Transcatheter valve trials:
100
■■
0
■■
CY 2012
AVR
CY 2013
MVR
Multi-Valve
CY 2014
Source: UVA Heart and Vascular Center Quality Office
■■
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
0
apien 3™ TAVR trial for
S
intermediate risk
patients
CY 2012
CY 2013
Gorav Ailawadi, MD, National Steering Committee
TAVRs
Other
■■
Isolated AVR Operative Mortality
20
Continued access to Partner II™ TAVR trial
CY 2014
Mitral Clips
irect Flow™ TAVR trial
D
Source:
UVA Heart and
Vascular Center
Quality Office
D. Scott Lim, MD,
National
Principal
Investigator
Mitralign™ trial for percutaneous tricuspid repair
Stroke prevention trials:
Minimally Invasive Valve Surgery
Cardiothoracic Surgical Trials Network
neuroprotection trial for aortic valve surgery patients
■■
60
3.0%
2.0%
■■
Sentinel trial for
TAVR patients
50
40
30
1.0%
20
10
9
VADS and Transplants
Thoracic Aortic Repair
Other
Pediatric Congenital
0
CY 2012
AVR
ource: Heart and Vascular Center Quality Office
Aortic Valve Surgery
UVAOperative
has been Mortality
instrumental in the development
Major Procedures
omparison of UVA’s
Operative
Mortality
to STS Mean*
of Risk-Adjusted
various open
surgical,
minimally
invasive and
percutaneous techniques for the treatment of
valve disease.
0%
Over the past three years, UVA surgeons performed
777 aortic valve surgeries, including 373 isolated AVR
surgeries, with exceptionally low mortality rates.
0%
0%
0%
CY 2013
MVR
CY 2014
Multi-Valve
Other
Source: UVA Heart and Vascular Center Quality Office
Isolated AVR Operative Mortality
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
3.0%
2.0%
1.0%
0.0%
2012
2013
2012
2014
2013
2014
UVA Risk-Adjusted Operative Mortality
UVA Risk-Adjusted Operative Mortality
STS Risk-Adjusted Operative Mortality
STS Risk-Adjusted Operative Mortality
UVAis allisSTS
among
Comparison of STS mean
Hospitalsthe top 8% of hospital nationally that
ource: 2014 STS National Adult Cardiac Surgery Database Report
achieved an overall three-star rating — the highest
*STS mean is all STS Hospitals
Source: 2014 STS National Adult Cardiac Surgery Database Report
possible — from The Society of Thoracic Surgeons
(STS) for aortic valve replacement surgery.*
lated CABG Operative Mortality
mparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
*There is no comparable rating system for mitral valve replacement or
tricuspid valve surgery.
Based on data comparisons from January 2012 through December 2014.
Source: 2014 STS National Adult Cardiac Surgery Database Report
%
AVR/CABG Operative Mortality
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
5.0%
4.0%
%
3.0%
2.0%
%
1.0%
0.0%
%
2012
2013
2012
2014
STS Risk-Adjusted Operative Mortality
STS Risk-Adjusted Operative Mortality
ve Procedures | 2012–2014
1263)
2014
UVA Risk-Adjusted Operative Mortality
UVA Risk-Adjusted Operative Mortality
ce: 2014 STS National Adult Cardiac Surgery Database Report
2013
*STS mean is all STS Hospitals
Source: 2014 STS National Adult Cardiac Surgery Database Report
In-Hospital Mortality: Risk-Adjusted O/E | 2014
TAVR/Mitral Clips | 2012–2014
U VA
STS
120
Isolated AVR
0.34
1.0
AVR/CABG
100
0.73
1.0
Source: 2014 STS National Adult Cardiac Surgery Database Report
80
60
40
10
20
0
AVR/CABG Operative
Mortality
TRANSCATHETER
AORTIC
VALVE REPLACEMENT
Comparison of UVA’s Risk-Adjusted Operative Mortality to STS Mean*
UVA was the first transcatheter aortic valve replacement
(TAVR)
center in Virginia. Our team has performed over
5.0%
300 TAVR procedures. UVA’s Advanced Cardiac Valve
4.0%
Center
is a national leader in the latest TAVR trials.
3.0%
Patients referred for TAVR are complex. UVA offers
2.0%
TAVR to three groups of patients: inoperable, high risk
1.0% intermediate risk.
and
0.0%
Inoperable
– Clinical trials 2013
and FDA-approved
2012
2014
options available
■■
Mitral Valve Repair and Replacements | 2012–2014
80
60
40
20
0
2012
MV Repair +/- CABG
UVA Risk-Adjusted Operative Mortality
Risk-Adjusted
Mortality
igh riskSTS
H
– Clinical
trialsOperative
and FDA-approved
options
■■
available
*STS
mean is all STS Hospitals
2013
2014
MV Replacement +/- CABG
Source: UVA Heart and Vascular Center Quality Office
Source: 2014 STS National Adult Cardiac Surgery Database Report
Intermediate risk – Clinical trial available
■■
TAVR is a minimally invasive procedure that requires a catheter to
be inserted through an artery. A surgeon positions the replacement
valve, then opens it with a balloon device.
TAVR/Mitral Clips | 2012–2014
Post-Implant Survival: Primary LVAD | 2012–2014
98% 95%
120
93% 91%
89% 87%
100
80% 81%
80%
12 Months
24 Months
72%
80
60
40
1 Month
20
UVA
0
CY 2012
TAVRs
CY 2013
CY 2014
3 Months
6 Months
Intermacs
Source: 2014 Intermacs Report
Mitral Clips
Source: UVA Heart and Vascular Center Quality Office
Minimally Invasive Valve Surgery
60
50
40
UVA Congenital Heart Surgery Volume
280
275
270
265
30
260
20
255
10
250
0
245
11
0
CY 2012
AVR
CY 2013
MVR
Multi-Valve
CY 2012
CY 2014
TAVRs
Other
CY 2013
Mitral Clips
ce: UVA Heart and Vascular Center Quality Office
Source: UVA Heart and Vascular Center Quality Office
Our surgeons
have a long history of expertise in
lated AVR Operative
Mortality
Minimally Invasive Valve Surgery
Mitral Valve Surgery
mparison of UVA’smitral
Risk-Adjusted
to STSdeveloped
Mean*
valveOperative
surgeryMortality
and have
techniques
%
%
%
%
now used across the country. While UVA cares for
extremely high-risk patients, our risk-adjusted, inhospital and operative mortality is less than national
average.
60
UVA surgeons performed 262 mitral valve surgeries
over the past three years, with exceptionally low
mortality rates.
20
2012
2013
50
40
30
10
0
2014
FY 2013
In 2014, despite
UVA Risk-Adjusted
Operativeoperating
Mortality on many complex patients,
Mini AVR
UVA had zero
mortalities
STS Risk-Adjusted
Operative
Mortality in patients undergoing
FY 2014
Mini MVR
isolated mitral valve surgery.
Source: UVA Heart and Vascular Center Quality Office
In-Hospital Mortality: Risk-Adjusted O/E | 2014
REPAIR VS. REPLACEMENT
S mean is all STS Hospitals
ce: 2014 STS National Adult Cardiac Surgery Database Report
U VA
STS
Isolated MV Repair
0.00
1.0
Isolated MV Replacement
0.00
1.0
Source: 2014 STS National Adult Cardiac Surgery Database Report
CY 2014
FY 2015
Total
UVA surgeons have a wealth of experience repairing
and replacing the mitral valve. Repair is often
associated with better survival and improved lifestyle,
as well as preserved heart function. There are fewer
complications associated with a mitral repair. However,
our surgeons are also experts in the latest techniques
in mitral replacement.
MINIMALLY INVASIVE SURGERY
UVA has performed over 130 minimally invasive
surgeries
for aortic
valve,
mitraltovalve
and tricuspid
Comparison of UVA’s
Risk-Adjusted
Operative
Mortality
STS Mean*
valve repairs and replacements.
AVR/CABG Operative Mortality
5.0%
4.0%
3.0%
2.0%
Our minimally invasive program is known throughout
the region with excellent repair rates and low mortality.
Our dedicated team has worked together closely since
the program’s inception in 2012.
Mitral Valve Repair and Replacements | 2012–2014
80
60
40
20
1.0%
0.0%
0
2012
2013
UVA Risk-Adjusted Operative Mortality
STS Risk-Adjusted Operative Mortality
2012
2014
MV Repair +/- CABG
2013
2014
MV Replacement +/- CABG
Source: UVA Heart and Vascular Center Quality Office
*STS mean is all STS Hospitals
Source: 2014 STS National Adult Cardiac Surgery Database Report
TAVR/Mitral Clips | 2012–2014
12
120
Post-Implant Survival: Primary LVAD | 2012–2014
98% 95%
UVA Advanced Cardiac Valve Center Surgical Director Gorav Ailiwadi, MD, and Medical Director D. Scott Lim, MD.
EXPERIENCE COUNTS
Our surgeons have significant experience with complex
and reoperative valve surgery, including extensive
experience in mitral valve repair.
■■
■■
CLINICAL TRIAL HIGHLIGHTS
■■
orav Ailawadi, MD, of our team was the first
G
cardiac surgeon in the U.S. to perform MitraClip®®
repair.
VA has performed the second-highest number of
U
MitraClip procedures in the nation during clinical trial.
■■
ational Institutes of Health-sponsored clinical
N
trial to determine how best to treat patients with
severe or moderate ischemic mitral regurgitation,
addressing the question of “repair vs. replacement.”
Irving Kron, MD, served as the national principal
investigator for the severe mitral regurgitation arm
of the trial.
linical Outcomes Assessment of the MitraClip
C
Percutaneous Therapy trial comparing medical
therapy to MitraClip in patients with functional mitral
regurgitation who are not candidates for surgery
13
Extracorporeal Membrane Oxygenation
In 2014, the UVA Extracorporeal Life Support
Program was honored by the Extracorporeal Life
Support Organization (ELSO) with the Award of
Excellence and was designated an ELSO Center
of Excellence.
Extracorporeal Membrane Oxygenation (ECMO)
uses a modified heart-lung machine to support
patients with the severest form of lung and/or heart
failure. Support can range from a few days to several
weeks in length depending on the severity of the
disease process.
■■
■■
Venovenous (VV) ECMO for pulmonary support
enoarterial (VA) ECMO for cardiac and pulmonary
V
support
Adult Support Survival Data
SUPPORT
T YPE
FY 2015
FY 2014
ELSO
NATIONAL
REGISTRY
VV
100% (2)
86% (6)
65%
VA
64% (11)
40% (8)
40%
ECPR
43% (7)
25% (6)
29%
Source: ELSO National Registry
Adult Survival to Discharge
SUPPORT
T YPE
FY 2015
FY 2014
ELSO
NATIONAL
REGISTRY
VV
50% (2)
86% (6)
56%
VA
55% (11)
0% (8)
40%
ECPR
14% (7)
13% (6)
29%
Source: ELSO National Registry
ADULT ECMO PROGRAM
■■
■■
edicated team on call 24/7 to respond to ECMO
D
emergencies in hospital
ransport team available for adult ECMO patient
T
transfers
Grayson Kirby, who was placed on ECMO following a serious
car crash, talking with his care team, including Thoracic Surgeon
James Isbell, MD.
14
PEDIATRIC ECMO TEAM
■■
■■
■■
rgent support for patients to help them recover
U
or to bridge to other therapy
Pediatric Support Survival Data
SUPPORT
T YPE
FY 2015
FY 2014
ELSO
NATIONAL
REGISTRY
mergent support for patients in cardiac or
E
respiratory arrest or near-arrest
VV
77% (9)
100% (8)
75%
VA
72% (11)
81% (11)
64%
upport for patients recovering from heart/lung
S
failure or heart surgery
ECPR
33% (3)
66% (3)
59%
■■
VV ECMO for pulmonary support
■■
VA ECMO for cardiac and pulmonary support
Source: ELSO National Registry
Pediatric Survival to Discharge
PEDIATRIC ECMO PROGRAM GROWTH
SUPPORT
T YPE
FY 2015
FY 2014
ELSO
NATIONAL
REGISTRY
The Pediatric ECMO Team is a dedicated group of
ECMO specialist and perfusionists, available in-house
for any emergency that could require ECMO support,
24 hours a day, seven days a week.
VV
77% (9)
88% (8)
74%
VA
27% (11)
45% (11)
41%
ECPR
33% (3)
33% (3)
41%
Source: ELSO National Registry
During FY 2015, our UVA Children’s Hospital ECMO
team made the first interfacility ECMO transport
with the Pegasus ground team. The team was called
to assist a hospital 145 miles away. The ECMO team
has since developed official interfacility transport
guidelines and has begun education initiatives with
the Pegasus and the Newborn Emergency Transport
System as we continue to develop a full-service
ECMO transport team.
15
Mechanical Circulatory Support for
Patients with Advanced Heart Failure
The field of heart failure medicine has advanced
tremendously over the past two decades.
Mechanical support devices, in particular, have
proven to be a safe and durable solution for patients
with end-stage heart failure. At the University of
Virginia, we
continue to offer the latest in heart
AVR/CABG Operative
Mortality
Comparison of UVA’s
Risk-Adjusted
Operative Mortality to STS Mean*
failure technologies.
5.0%
■■
4.0%
3.0%
■■
2.0%
1.0%
ur heart failure team continues to grow with the
O
addition of two cardiologists who specialize in the
treatment of advanced heart failure.
e also expanded our Advanced Heart Failure
W
Nurse Practioner service.
VA is a national leader in ventricular assist device
U
(VAD) technologies, providing therapy for both
2012
2013
2014
adults and children.
NEW TECHNOLOGY
UVA now offers the SynCardia®® total artificial
heart (TAH) as an option for mechanical
circulatory support for patients with advanced
Mitral Valve Repair and Replacements | 2012–2014
biventricular heart failure.
80
■■
60
■■
40
20
■■
0.0%
UVA Risk-Adjusted Operative Mortality
VA is the only center in Virginia with a pediatric
U
and adult mechanical circulatory support (MCS)
*STS mean is all STS Hospitals
and transplant program.
■■
STS Risk-Adjusted Operative Mortality
Source: 2014 STS National Adult Cardiac Surgery Database Report
COLLABORATION
UVA is committed to helping our VAD patients return
home. We partner closely with referring physicians,
providing consultation as necessary to ensure
successful follow-up care. We also work closely with
emergency rooms at local hospitals, rescue squads,
home health and cardiac rehab centers, providing the
training needed to care for patients with left-ventricular
assist devices (LVADs).
TAVR/Mitral Clips | 2012–2014
120
100
80
60
he TAH replaces both heart ventricles,
T
improving the symptoms of end-stage
biventricular failure.
he SynCardia TAH is now available with the
T
Freedom Driver console. This console allows
patients to transition to home as they await
heart transplantation.
0
2012
Post-Implant Survival: Primary LVAD | 2012–2014
98% 95%
1 Month
20
UVA
CY 2012
TAVRs
CY 2013
Mitral Clips
Source: UVA Heart and Vascular Center Quality Office
Minimally Invasive Valve Surgery
60
50
CY 2014
93% 91%
3 Months
89% 87%
6 Months
80% 81%
80%
12 Months
24 Months
72%
Intermacs
Source: 2014 Intermacs Report
JOINT COMMISSION CERTIFICATION
UVA is one of the few facilities in the region with
Advanced Certification from the Joint Commission for
Heart Failure and Ventricular Assist Devices.
UVA Congenital Heart Surgery Volume
280
16
2014
MV Repair +/CABG includes
MV Replacement
CABG
Post-implant
survival
long-term,+/FDAapproved
mechanical
circulatory
Source:
UVA Heart
and Vascular Center
Quality Officesupport devices
for patients on the heart transplant list, as well as
individuals that desire extended survival and are not
heart transplant candidates.
40
0
2013
275
270
Heart Failure Specialist Sula Mazimba, MD, MPH (center) and Jennifer Christy, RN (right).
CLINICAL TRIAL HIGHLIGHTS
■■
■■
s one of 60 centers participating in the
A
MOMENTUM 3 clinical trial, the UVA heart failure
team will evaluate the safety and efficacy of the
latest generation of LVAD, the HeartMate 3®™. This
device is completely magnetically levitated, removing
the need for mechanical bearings. This device should
result in improved hemocompatibility and minimize
late thrombotic and bleeding complications.
VA was the first to enroll nationally in the
U
Cardiothoracic Surgical Trials Network VAD Stem
Cell trial evaluating the efficacy of stem cell injection
at the time of LVAD implant. The study determines
the impact of stem cells on the recovery of heart
function.
17
Transplantation
One of the pioneers in heart and lung transplant
in the state, UVA performed its first heart transplant
in 1989 and its first lung transplant in 1990. With
over 45 years of experience in organ transplant our
medical teams are some of the most experienced
in the country. As part of the only Comprehensive
Transplant Center Virginia, our lung and heart
programs have achieved the highest survival rates
in the country.
LUNG TRANSPLANTATION
First in the state, our Lung Transplant Program
is in its 25th year and has performed more than
400 successful transplants. The goal of our expert,
multidisciplinary team is to improve the quality of
life of our patients and to extend their lives either
through transplant or other innovative surgical
and/or medical therapies.
■■
■■
■■
■■
■■
ibrocyte and lung transplantation study that looks
F
at the level of fibrocytes in transplant recipients to
see if it correlates with the development of chronic
lung rejection.
true bench-to-bedside study utilizing novel
A
compounds developed at UVA that show great
promise to decrease acute lung transplant injury.
Scientific Registry of Transplant Recipients
1-Year Patient Survival
SRTR JUNE 2015 RELEASE
U VA
NATION
Lung Transplant
100%
87.47%
Adult Heart Transplant
100%
90.39%
Pediatric Heart Transplant
100%
92.87%
Source: Scientific Registry of Transplant Recipients
UVA performs 15 to 20 lung transplants annually.
In 2014, our lung transplant program achieved
a 100% one-year survival rate and is continuing
that track record in 2015.
his year we added ex-vivo lung perfusion
T
technology, which will increase the number of
suitable organs.
Ex-vivo technology is only offered by a handful of
centers in the world and is part of the solution to
the donor shortage problem. Ex-vivo lung perfusion
allows for the rehabilitation of lungs that would
otherwise be unsuitable for transplant.
18
CLINICAL TRIAL HIGHLIGHTS
HEART TRANSPLANTATION
VA Heart Transplant program is the top heart
U
transplant center in Virginia, having performed over
450 transplants. It is this experience that has allowed
us to transplant patients as young as 6 days old to
our oldest patient of 73 years. Our experience is also
reflected in our heart transplant survival statistics,
which exceed national averages, achieving 100%
one-year survival in the 2015 SRTR Release.
ADULT HEART TRANSPLANTATION
PEDIATRIC HEART TRANSPLANTATION
We are the most experienced heart transplant program
in the state.
UVA is Virginia’s only comprehensive pediatric heart
transplant and pediatric mechanical circulatory support
program in the state.
■■
ccording to the 2015 Scientific Registry of
A
Transplant Recipients (SRTR) Report:
Performed 26 adult grafts within the report’s time
period.
Waitlist mortality rate below the regional average –
5.8 vs. 16.2.
■■
■■
■■
■■
Photo credit: Julia Swanson, MD
■■
VA offers both VAD and TAH as bridge to transplant
U
or as an option for patients who do not qualify for
transplant.
■■
■■
VA performed its first pediatric heart transplant in
U
1991 and performed 11 transplants in 2014.
In the last 36 months, UVA performed 23 pediatric
heart transplants with a 30-day mortality rate of 0%.
VA is a pioneer in the use of VAD in children who
U
are awaiting transplant.
VA has the most comprehensive congenital heart
U
center in Virginia and the largest fetal heart program.
“Heart transplantation is the ultimate example of teamwork. Over the past 36 months, we have
seen a significant increase in our pediatric heart
transplantation program, performing 23
pediatric heart transplants. This increase is a
result of putting together a group of people who are dedicated to the field of pediatric heart
failure and transplantation. The dedication, work ethic, enthusiasm and collaboration of our team ensure the best quality of care and
outcomes for the patients. At the same time, it makes the experience for the patient and their
families as smooth and pleasant as possible. It gives all members of the program a tremendous
satisfaction and pride to be part of something so special.”
— JAMES GANGEMI, MD
Left: James Gangemi, MD, with friend and mentor John Kern, MD, during a pediatric heart transplant.
19
Post-Implant Survival: Primary LVAD | 2012–2014
98% 95%
93% 91%
89% 87%
Norwood Procedure Volume
12
80% 81%
80%
10
72%
Congenital Heart Surgery
8
6
4
1 Month
3 Months
6 Months
12 Months
24 Months
UVA
is the largest
and most
comprehensive
congenital
heart center in Virginia.
UVA
Intermacs
Mitral Valve Repair
and
Replacements | 2012–2014
O
ver
the
past
three years, UVA Pediatric Congenital
Source: 2014 Intermacs Report
Heart Surgery Program performed over 800
80
surgeries.
■■
ur program growth is reflected in a 16% increase in
O
operations submitted to the STS from 2013 to 2014.
40
Arterial switches
30
Truncus arteriosus repairs
20
Total anomalous pulmonary venous return repairs
■■
■■
■■
10
oo
d
s
cu
nt
un
an
n
Gl
en
SD
rw
Tr
Fo
0%
STAT 1
245 Survival: Primary LVAD | 2012–2014
Post-Implant
FY 2013
FY 2014
24 Months
STAT 5
STS Congenital Heart Database
Comparing Complexity
UVA to STS Congenital Database 2011–2014
2
Intermacs
40
STAT 4
10
4
12 Months
STAT 3
Source: 2014 STS Congenital Database Report
6
January 2011- December 2014
6 Months
12
8
Postoperative Median Length of Stay
3 Months
STAT 2
UVA Children’s
Hospital
Norwood Procedure
Volume
FY 2015
98% 95% Source:
UVA91%
Division of Thoracic and Cardiovascular Surgery, Congenital Heart Surgery
93%
89% 87%
80% 81%
80%
72%
0
2012
Source: 2014 Intermacs
Report
30
2013
6.2%
4.2%
17.3%
20.6%
10.9%
2014
11.5%
Source: UVA Division of Thoracic and Cardiovascular Surgery, Congenital Heart Surgery
34.7%
20
10
UVA CongenitalUVA
Heart Surgery
Volume
STS
Source: 2014 STS Congenital Database Report
s
oo
d
rw
cu
No
an
nt
un
Tr
Fo
en
n
Gl
+V
SD
O
AS
AS
O
Ca
n
al
F
D
VS
TO
AV
Co
ar
ct
at
io
n
0
86.4% – One-year survival rate for Norwood
surgery
30.9%
compared to the national average of 74%, according to
the Pediatric Heart NetworkUVA
Single Ventricle Trial.
Pediatric Heart Surgery
STAT 1 Survival
STAT 2
STAT 3
STS-EACTS STAT Mortality Category | 2014
Source: 2014 STS Congenital Database Report
80%
270
Norwood Procedure Volume
20
12
60%
Aortic Procedures | FY 2013–2015
40%
20%
0%
200
STAT 1
STAT 2
STAT 3
STAT 4
32.7%
31.0%
STS
STAT 4
100%
275
255
O
Adult congenital
250
260
+V
Source: 2014 STS Congenital Database Report
20%
■■
255
265
O
Heterotaxy
40% syndrome
■■
260
280
No
Co
UVA 60%STS
265
UVA
l
100%
omplex
C
valve repairs, among a host of complicated
80%
procedures
270
Source: UVA Heart and Vascular Center Quality Office
1 Month 50
AS
n
io
at
■■
MV Replacement +/- CABG
AS
275 +/- CABG
MV Repair
2014
ct
2013
na
■■
280
2012
F
0
Pediatric
Interrupted
aorticHeart
arch Surgery
repairs Survival
STS-EACTS
STAT
Mortality Category | 2014
0
Complex aortic arch reconstructions
Ca
■■
TO
UVA Congenital Heart Surgery Volume
ar
20
2014
Source: UVA Division
of Thoracic
and Cardiovascular
Surgery,
Congenital Heart Surgery
ingle-ventricle
S
palliation
surgeries,
including
the
Norwood procedure
AV
40
50
D
■■
■■
VS
60
At UVA, we2 have experience in the diagnosis and
treatment 0of the full range of congenital heart and
Postoperative Median Length of Stay
vascular
defects. Surgeries
we perform
include:
2013
January 2011- December2012
2014
STAT 5
STAT 5
UVA Children’s Hospital Heart Center team members (left-right): Pediatric Cardiologist Thomas L’Ecuyer, MD; Adult and Pediatric
Congenital Heart Surgeon James Gangemi, MD; and Pediatric Cardiologist William Harmon, MD.
UVA CHILDREN’S HOSPITAL HEART CENTER
Our pediatric heart center offers:
■■
■■
■■
■■
he most comprehensive congenital heart center
T
in Virginia
he largest fetal heart program in Virginia treating
T
high-risk infants
he largest pediatric pulmonary hypertension
T
clinic and the only Hypertrophic Cardiomyopathy
Association Center of Excellence in Virginia
he Cardiovascular Genetics Clinic, which tests for
T
risks of inherited heart or vascular disease
EXPRESSIONS OF GRATITUDE
“We want to thank you and your entire team for everything you have done for our grandson…. We feel that you have given him a wonderful
brand new start to life
“We will never be able to thank you enough for all that you did for our little girl! You cared for her as a person and not just a patient.”
“You saved my life and I am forever grateful...
I have more self confidence than ever. I feel
better than ever, too. You are an amazing
surgeon and if I ever do need another open heart surgery, I would gladly choose you.”
21
Post-Implant Survival: Primary LVAD | 2012–2014
98% 95%
1 Month
UVA
Congenital Heart Surgery (continued)
93% 91%
89% 87%
80% 81%
80%
72%
Norwood Procedure Volume
12
10
DEDICATED TEAMS
8
STAT
MORTALITY CATEGORY
An integrated team of experts in all aspects of
congenital heart surgery is the key to our low operative
mortality
dedicated
3 Monthsand quality
6 Monthsoutcomes.
12 MonthsOur 24
Months
pediatric congenital team includes:
6
The
STS and European Association for Cardiothoracic
Surgery
(EACTS) Congenital Heart Surgery Mortality
4
Categories (STS-EACTS STAT Mortality Category)
2
system is an objective, empirically based index that can
0
be used to estimate the risk of in-hospital mortality by
2012
2013
2014
procedure and measure the complexity of patients.
Source:
UVA Division
of Thoracic
and Cardiovascular
Surgery,complex
Congenital Heart
The
greater
the
risk category,
the more
theSurgery
case and the risk of mortality.
Intermacs
ediatric Cardiac Intensive Care Unit (PCICU)
P
staffed with nurses and intensivists, which includes
two intensivists who are double board-certified in
pediatric cardiology and pediatric intensive care. The
team focuses on the postoperative care of babies
and children undergoing congenital heart surgery.
■■
Source: 2014 Intermacs Report
ediatric cardiac step-down unit with specialized
P
nursing and therapists, in an effort to improve care
UVA Congenital Heart Surgery Volume
and provide earlier discharges
In 2014, our overall mortality for STS-eligible
procedures was less than the national average.
■■
280
ediatric operating room team, staffed by
P
pediatric specialists, including pediatric cardiac
anesthesiologists and cardiac perfusionists
■■
275
270
265
ediatric ECMO Team for 24/7 care with neonatal
P
and pediatric transport teams capable of pre-ECMO
and ECMO transport
■■
260
255
CLINICAL TRIAL HIGHLIGHTS
245
FY
2013
■■
60%
40%
20%
0%
STS
rce: 2014 STS Congenital Database Report
FY 2015
UVA to STS Congenital Database 2011–2014
6.2%
4.2%
17.3%
20.6%
10.9%
11.5%
34.7%
32.7%
30.9%
31.0%
d
s
STAT 5
STS Congenital Heart Database
UVA
STAT 1
STAT 2
STS
STAT 3
Source: 2014 STS Congenital Database Report
22
orwood Procedure Volume
STAT 4
Comparing Complexity
rw
oo
cu
un
STAT 3
Source: 2014 STS Congenital Database Report
No
Tr
n
nt
an
Fo
Gl
en
SD
+V
O
O
AS
AS
al
F
AV
Ca
n
TO
D
VS
rc
oa
STAT 2
t. Jude’s HALO valve trial – A 15mm, rotatable
S
mechanical heart valve, the world’s smallest pediatric
mechanical heart valve
■■
n
80%
UVA Children’s Hospital
FY 2014
n-X 17mm Aortic Prosthetic Heart Valve and
O
23mm
Mitral
Prosthetic
Heart
ValveHeart
– Investigating
Source: UVA Division
of Thoracic
and Cardiovascular
Surgery,
Congenital
Surgery
safety and efficacy of a smaller-sized prosthetic
valve.Length
UVA is of
one
of 15 centers in the world
ostoperative Median
Stay
uary 2011- December
2014
investigating the On-X valves.
ta
tio
100%
STAT 1
250
UVA
Pediatric Heart Surgery Survival
STS-EACTS STAT Mortality Category | 2014
Aortic Procedures | FY 2013–2015
STAT 4
STAT 5
Complex Aortic Disease
UVA is a regional referral center for all aspects
Comparing
Complexity
of aortic and
vascular diseases, with more than
Vascular Volumes | 2012–2014
UVA
STS Congenital
Database 2011–2014
fourtodecades
of experience.
Our cardiac and
(n = 2486 )
vascular surgeons performed 2,486 major vascular
4.2%
procedures and 4646.2%
complex aortic procedures
20.6%
17.3%
over the past three years.
■■
600
500
10.9%
11.5%
reatment options include participation in clinical
T
trials and genetic screening.
34.7%
400
32.7%
■■
urgical options range from minimally invasive or
S
percutaneous endovascular
aneurysm repair to31.0%
30.9%
complex staged hybrid total aortic replacement of
the ascending aorta, aortic arch, descending thoracic
UVA
STS
aorta and abdominal aorta.
STAT 1
STAT 2
STAT 3
STAT 4
ur team has extensive experience in treating
O
Source:
2014dissection,
STS Congenital Database
Report
aortic
thoracoabdominal
aneurysms
and connective tissue disorders.
■■
300
200
100
STAT 5
Aortic OR team0(left-right): John Angle, MD; John Kern, MD;
CY 2012
2013Sabri, MD.
Kenneth Cherry, MD; Ravi
Ghanta, MD; and CY
Saher
PVI
AORTIC ALERTCarotid Endarterectomy
Aortic Procedures | FY 2013–2015
Endovascular AAA Repair
CY 2014
Lower Extremity Bypass
Thoracic/Complex EVAR
Open AAA Repair
Prompt, accessible care for aortic emergencies
Carotid Artery Stent
UVA has established an aortic alert process,
UVA Heart and Vascular Center Quality Office
enablingSource:
emergency
rooms and referring
physicians to rapidly effect a transfer for anyone
with acute aortic disaster.
Thoracic Surgery Volume | 2014
System puts referring physicians in touch with
a UVA attending cardiac or vascular surgeon
1000
any time, day or night.
200
150
100
■■
50
■■
0
FY 2013
FY 2014
FY 2015
Dissection-Type B
Dissection-Type A
Repair of Thoracoabdominal
Aneurysm
Repair of Aneurysm of the Arch
TEVAR
Aortic Root
Repair of Descending Aortic Aneurysm
Repair of Ascending Aortic Aneurysm
Source: UVA Heart and Vascular Center Quality Office
■■
800
perator
O
connects both the cardiac and
vascular
attending triage officers on the call in
600
order to decide the best treatment option for
400
the patient.
If determined
to be an emergency, teams are
200
alerted and ready for the arrival of the patients.
0
This ensures the right team is available for the
right patient at the right
the right
UVAtime with
Community
Partner
equipment,
resources and expertise.
Source: UVA Heart and Vascular Center Quality Office
For a consult on aortic emergencies, please call
the Aortic Alert line: 844.933.7882
UVA Thoracic Surgery | 2012–2014
Lung Surgery – 592
Esophageal Surgery – 143
23
Benign Esophageal Surgery – 346
Complex Aortic Disease (continued)
HYBRID OPERATING SUITE
VASCULAR QUALITY INITIATIVE
The hybrid OR is used for a multidisciplinary approach,
allowing for real-time collaboration, combining
medical and surgical expertise with the most advanced
technology available. UVA is fortunate to offer
technically advanced facilities, including four stateof-the-art hybrid operating rooms, allowing for less
invasive procedures.
The Society for Vascular Surgery’s Vascular Quality
Initiative (SVS VQI) is designed to improve the quality,
safety, effectiveness and cost of vascular healthcare by
collecting and exchanging information. UVA is an active
member of the Vascular Quality Initiative (VQI).
■■
■■
■■
■■
■■
quipped with the most advanced imaging
E
technology
nables simultaneous performance of percutaneous
E
and open procedures
Gilbert R. Upchurch Jr., MD, is the medical director
of the Virginias Vascular Study Group — a group
of hospitals and vascular specialists committed to
collecting, sharing and analyzing data related to
vascular interventions and outcomes in Virginia and
West Virginia.
educes the risk of complications and length of
R
stay associated with multiple procedures
eams work closely together to offer complex
T
treatments and surgeries for patients requiring
more in-depth procedures
Increases efficacy and success of complex
procedures
Vascular and Endovascular Surgeon Gilbert R. Upchurch Jr., MD.
Rate of Major Complications After
Infrainguinal Bypass, January 2014–May 2015
Complication Rate
U VA
SVS VQI
0%
4%
Source: 2015 SVS VQI Regional Report
Nonruptured Open AAA In-Hospital Mortality
January 2014–May 2015
U VA
SVS VQI
Observed Rate
0.0%
3.5%
Expected Rate
2.3%
Source: 2015 SVS VQI Regional Report
24
QUALITY
IMPROVEMENT
Thoracic:
All Surgeries | 2012–2014
Vascular Volumes | 2012–2014
Volumes
and
30-Day
Mortality
(%)
Our complex
aortic
disease
program
provides
comprehensive care, including:
600
500
■■
400
1000
2.5%
800
2.0%
Smoking cessation
ptimizing
O
glucose control to reduce risk of wound
600
infection
400
■■
300
hysical therapy consulted on every post-op lower
P
200
extremity surgical revascularization
200
100
0
■■
CY 2012
CY 2013
CY 2014
PVI
Lower Extremity Bypass
Carotid Endarterectomy
Thoracic/Complex EVAR
Endovascular AAA Repair
Open AAA Repair
Carotid Artery Stent
Source: UVA Heart and Vascular Center Quality Office
1.0%
0.5%
0
■■
1.5%
ischarged vascular
D
antiplatelet and
2012patients on
2013
2014
statin
Patients
30-Day Mortality (%)
30-Day Mortality (%)
■■
Volume
(n = 2486 )
0.0%
Follow-up
greater
than
SVS
VQIOffice
average
Source: visits
UVA Heart
and Vascular
Center
Quality
CLINICAL TRIAL HIGHLIGHTS
The Aortic Aneurysm Research Laboratory, led by
Gilbert R. Upchurch Jr., MD, and Gorav Ailawadi, MD,
Lung Surgery
is dedicated to pioneering research and discovering
UVA 30-Day Mortality (%)
the mechanisms of aneurysm formation and
prevention.
2.0%
■■
Research funding totaling $6.2 million
■■
3 NIH R01 grants to study aneurysms
1.5%
PARTNERS IN CARE
Thoracic Surgery Volume | 2014
Complex aortic disease care at UVA features a
multidisciplinary team of experts, including:
1000
n outstanding genetics program to evaluate
A
800
patients with aortic pathologies and connective
600
tissue disorders, such as bicuspid aortic valve,
Marfan syndrome and Loeys Dietz syndrome. The
400
program also offers the ability to screen at-risk
family members.
200
■■
1.0%
2 ongoing IRB-approved clinical trials involving
1
abdominal
0.5% aortic aneurism/thoracic aortic aneurism
disease
0.0%
■■
■■
0n anesthesia team dedicated to the use of
A
techniques designed to minimize complications
UVA
Community Partner
of aneurysm repairs
Source: UVA Heart and Vascular Center Quality Office
ndovascular specialists dedicated and skilled in
E
angioplasty, atherectomy, stenting, thrombectomy
and
thrombolysis
techniques
UVA
Thoracic
Surgery
| 2012–2014
■■
Lung Surgery – 592
Esophageal Surgery – 143
Benign Esophageal Surgery – 346
Lung Transplant Procedures – 44
2010–2012
2011–2013
UVA 30-Day Mortality (%)
2012–2014
STS 30-Day Mortality (%)
Note: Year represents “end year” of STS’s rolling 3 years.
Source: UVA Heart and Vascular Center Quality Office
Esophageal Surgery
UVA 30-Day Mortality (%)
5.0%
4.0%
3.0%
2.0%
1.0%
25
0.0%
2010–2012
2011–2013
2012–2014
Dissection-Type B
Dissection-Type A
Repair of Thoracoabdominal
Aneurysm
Repair of Aneurysm of the Arch
TEVAR
Aortic Root
200
Repair of Descending Aortic Aneurysm
Repair of Ascending Aortic Aneurysm
Thoracic Surgery
0
UVA
Source: UVA Heart and Vascular Center Quality Office
atients considered inoperable or too high risk for
P
200
a thoracic surgical procedure are often referred to
UVA for a second opinion.
he thoracic surgery programs provide state-ofT
0the-art treatment options, advanced technology and
CY 2012
CY 2013
CY 2014
multidisciplinary
treatment
strategies.
PVI
Endovascular AAA Repair
Volume
Benign Esophageal Surgery – 346 2.0%
600
Lung Transplant Procedures – 44 1.5%
400
1.0%
0.5%
2013
2014
■■
Lung cancer
■■
Esophageal cancer
■■
■■
■■
30-Day Mortality (%)
enign
B
esophageal
Lung
Surgery diseases (e.g., hiatal hernias
UVA 30-Day Mortality
and gastroesophageal
reflux(%)
disease)
Malignant mesothelioma
L ung volume reduction surgery
1.5%
(emphysema
surgery)
Pulmonary
1.0% metastases
Mediastinal
adenopathy (enlarged lymph nodes)
0.5%
Pleural effusions (fluid around the lungs)
0.0%
■■
600
■■
400
2011–2013
2012–2014
chalasia, and 2010–2012
A
other motor disorders
of the
esophagus
UVA 30-Day Mortality (%)
STS 30-Day Mortality (%)
Small,Note:
indeterminate
lung nodules
Year represents “end year” of STS’s rolling 3 years.
Source: UVA Heart and Vascular Center Quality Office
■■
Chest wall tumors
200
■■
Chest wall deformities (i.e., pectus excavatum)
0
■■
UVA
Community Partner
Source: UVA Heart and Vascular Center Quality Office
■■
■■
UVA Thoracic Surgery | 2012–2014
Lung Surgery – 592
26
Esophageal Surgery – 143
0.0%
2.0%
■■
■■
800
1
UVA thoracic
surgeons provide consultation and
Source: UVA Heart and Vascular Center Quality Office
care for patients with:
■■
1000
2012
AREAS OF EXPERTISE
Patients
■■
Thoracic Surgery Volume | 2014
2.5%
800
0
Open AAA Repair
VA has
U
partnered
with nearby facilities in order to
Carotid
Artery Stent
bring our surgical skills closer to the patients and the
Source:
UVA Heart andinVascular
Center
Quality
Office
community
which
they
live.
2
200and Vascular Center Quality Office
Source: UVA Heart
Lower Extremity Bypass
horacic surgeons are a part of a growing thoracic
T
Thoracic/Complex EVAR
Carotid Endarterectomy
oncology team at UVA Cancer Center.
3
Esophageal Surgery – 143
1000
■■
100
4
Thoracic: All Surgeries | 2012–2014
Volumes and 30-Day Mortality
(%)
Lung Surgery
– 592
30-Day Mortality (%)
We have established ourselves as leaders in the
400
Southeast
and nationally. We provide care here at UVA
and have partnered with other facilities in the area in
300
order
to provide care to patients closer to their homes.
5
UVA Thoracic Surgery | 2012–2014
500
■■
E
U
Source: UVA Heart and Vascular Center Quality Office
The University of Virginia’s thoracic surgery
program provides care to patients with lung and
Vascular Volumes | 2012–2014
esophageal
disease. We offer a comprehensive
(n = 2486 )
assessment and provide close collaboration with
multiple
subspecialists in order to decide on the
600
best treatment option for the patient.
■■
Community Partner
ediastinal tumors
M
(e.g., thymomas and myastenia gravis)
Esophageal Surgery
Tracheal
and
strictures
UVAtumors
30-Day
Mortality
(%)
hotodynamic therapy for lung and esophageal
P
5.0%
cancers
4.0%
3.0%
2.0%
1.0%
0
N
S
THORACIC SURGERY OUTCOMES
UVA is committed to advancing the database and
improving the reporting process that drives quality
improvement and patient safety strategies.
ur efforts have produced remarkable results in
O
the improvement of care and are reflected in our
discharge mortality and 30-day mortality results.
■■
enjamin Kozower, MD, was appointed chair of the
B
STS General Thoracic Surgery Database Task Force
in January 2015.
■■
ALL PATIENTS
2014
JAN 2012–
DEC 2014
JAN 2002–
DEC 2014
UVA Discharge
Mortality
0.5%
0.8%
1.6%
STS Discharge
Mortality
1.7%
1.7%
2.3%
UVA 30-Day
Mortality
1.3%
1.2%
2.2%
STS 30-Day
Mortality
2.1%
2.1%
3.2%
Source: 2014 STS General Thoracic Report
Benign Esophageal Surgery | 2014
Contribution to Total Procedures (%)
Thoracic: All Surgeries | 2012–2014
Volumes and 30-Day Mortality (%)
800
2.0%
600
1.5%
400
1.0%
200
0.5%
Volume
2.5%
0
2012
2013
Patients
2014
EXPRESSION OF GRATITUDE
100%
30-Day Mortality (%)
1000
0.0%
30-Day Mortality (%)
3%
9% I
“I truly believe you saved my life, and for that
am eternally
grateful. You not only took me16%
on
80%
as a patient but you looked at me as a person.
That 60%
means a lot, especially to someone that
believes they are not going to live through health
problems. Thank you and your team for being so
40%
nice and patient, for not giving up on me.” 73%
20%
Source: UVA Heart and Vascular Center Quality Office
0%
Hiatal Hernia and GERD
Lung Surgery
UVA 30-Day Mortality (%)
Achalasia
Diverticulum
Other
Source: UVA Heart and Vascular Center Quality Office
Atrial Fibrillation Correction Surgery | 2012–2014
2.0%
(n = 250)
1.5%
100
1.0%
80
0.5%
60
0.0%
2010–2012
2011–2013
UVA 30-Day Mortality (%)
2012–2014
STS 30-Day Mortality (%)
Thoracic
Surgeon“end
Benjamin
Kozower,
MD. and Christine Baker, RN.
Note: Year represents
year” of STS’s
rolling 3 years.
Source: UVA Heart and Vascular Center Quality Office
40
20
0
CY 2012
Lone AFIB Ablation
CY 2013
CY 2014
Concomitant AFIB Ablation
Source: UVA Heart and Vascular Center Quality Office
27
Volume
2.0%
600
1.5%
400
1.0%
Thoracic
Surgery (continued)
200
0
2012
2013
Patients
LUNG SURGERY
0.5%
2014
30-Day Mortality (%)
6
800
0.0%
3%
9%
16%
80%
60%
40%
73%
30-Day Mortality (%)
Source:
UVAtreatment
Heart and Vascular
Office
For the
of Center
stageQuality
I lung
cancer,
minimally
invasive surgery is utilized in 61.2% of the cases.
Our 30-day operative mortality is below national
benchmarks, despite the complexity of the patients.
Lung Surgery
UVA 30-Day Mortality (%)
20%
0%
Hiatal Hernia and GERD
Achalasia
Diverticulum
Other
Source: UVA Heart and Vascular Center Quality Office
Atrial Fibrillation Correction Surgery | 2012–2014
2.0%
(n = 250)
1.5%
100
1.0%
80
0.5%
60
0.0%
2010–2012
2011–2013
UVA 30-Day Mortality (%)
2012–2014
STS 30-Day Mortality (%)
Note: Year represents “end year” of STS’s rolling 3 years.
Source: UVA Heart and Vascular Center Quality Office
CLINICAL TRIAL HIGHLIGHTS
obectomy vs. sublobar resection for small
L
peripheral non-small cell lung cancer (CALGB14503)
Esophageal
– OngoingSurgery
trial at multiple sites looking at early lung
UVA
30-Day
Mortality (%)
cancers
in comparing
outcomes with lobectomies
verses lesser resections
40
20
0
CY 2012
Lone AFIB Ablation
CY 2013
CY 2014
Concomitant AFIB Ablation
Thoracic Surgeons (left-right): Benjamin Kozower, MD;
Source: UVA Heart and Vascular Center Quality Office
Christine
Lau, MD; and James Isbell, MD.
■■
5.0%
issue procurement for protocol for development
T
therapeutics – Multi-institutional trial, of which UVA is
3.0%
a participant, collecting lung cancer specimens from
2.0%
patients in the hope of providing future benefits and
1.0%
improvement in lung cancer survival
■■
4.0%
0.0%
■■
Empress
lung ablation study – New study looking at
2010–2012
2011–2013
2012–2014
comparing utilization novel technology to ablate small
UVA 30-Day Mortality (%)
STS 30-Day Mortality (%)
lung cancers
Note:
Year represents lung
“end year”
of STS’s rolling 3trial
years.–
■■
Adenosine
transplant
Source: UVA Heart and Vascular Center Quality Office
Study looking at
patients who undergo lung transplantation to see if the
use of adenosine derivatives decrease inflammation
and prevent ischemia reperfusion injury in lung
transplantation
28
Cardiovascular
Thoracic Publications
EXPRESSIONS
OF GRATITUDE
120 to your diligence, I now have the answer.
“Thanks
Not100
only that, I now have a prognosis. Please
accept
80 my thanks for going that extra mile.
[Referring
doctor] says my disease is ‘one in a
60
million.’ I would say the same about you.”
40
20
“We were routinely visited by literally teams of
0
doctors
who addressed
every2013
medical issue and
2012
2014
concern in the detail. We would like to identify
Source: Thoracic and Cardiovascular Lab
them as leaders and role models in their field.”
44
Hiatal Hernia and GERD
Lung Surgery
UVA 30-Day Mortality (%)
Achalasia
Diverticulum
Other
Source: UVA Heart and Vascular Center Quality Office
Atrial Fibrillation Correction Surgery | 2012–2014
2.0%
ESOPHAGEAL SURGERY
(n = 250)
BENIGN
ESOPHAGEAL DISEASE
1.5%
In addition to procedures for esophageal cancers,
100
our thoracic surgeons perform a large number of
80
operations
for benign (noncancerous) diseases of the
esophagus,
including hiatal hernias, gastroesophageal
60
reflux disease (GERD), achalasia and esophageal
40
diverticuli.
Esophageal surgery at UVA involves the treatment of
complex paraesophageal hernias, esophageal cancer
1.0%
and esophageal reconstruction. UVA surgeons provide
0.5%
a variety of open and minimally invasive approaches to
optimize outcomes.
0.0%
2010–2012
2011–2013
2012–2014
Esophagectomy
Median
Length
UVA 30-Day
Mortality
(%) of Stay
STS 30-Day Mortality (%)
Note: Year represents “end year” of STS’s rolling 3 years.
Source: UVA Heart and Vascular Center Quality Office
2012–2014
UVA
STS
8 days
10 days
■■
■■
Source: Heart and Vascular Center Quality Office
■■
Esophageal Surgery
UVA 30-Day Mortality (%)
he20
T
majority of the benign esophageal surgeries at
UVA are
performed laparoscopically or robotically
0
CY 2012 approach).CY 2013
CY 2014
(minimally invasive
AFIB Ablation
AFIB Ablation
inimallyLone
M
invasive
approachConcomitant
reduces pain,
the length
of stay
and
timeand
away
from
Source:
UVA Heart
Vascular
Centerwork.
Quality Office
VA’s median length of stay for benign esophageal
U
disease surgery is two days.
Cardiovascular Thoracic Publications
Benign
120Esophageal Surgery 30-Day Mortality
5.0%
4.0%
UVA
3.0%
UVA 30-Day Mortality (%)
2012–2014
200
2.5%
2.0%
1.5%
CLINICAL TRIAL HIGHLIGHTS
0
1.0%
enign esophageal study – Study at UVA0.5%
B
that looks
at outcomes following benign esophageal surgery
2012
2013
2014
0.0%
atient-reported outcomes for with lung and
P
Patients cancer – Study
30-Dayfunded
Mortality (%)
esophageal
by the PatientOutcomes
Research
Institute (PCORI) that
Source: UVACentered
Heart and Vascular
Center Quality
Office
evaluates the impact of surgery on patient-reported
outcomes and their relationship to procedure type
■■
80
0.78%
0.92%
0.97%
2012
100%
30-Day Mortality (%)
Note: Year represents “end year” of STS’s rolling 3 years.
Source: UVA Heart and Vascular Center Quality Office
■■
2014
Benign Esophageal Surgery | 2014
0
Contribution
to Total Procedures (%)
STS 30-Day Mortality (%)
600
400
2013
20
0.0% All Surgeries | 2012–2014
Thoracic:
2010–2012
Volumes and 30-Day
Mortality 2011–2013
(%)
800
2012
40
1.0%
1000
100
60
Source: Heart and Vascular Center Quality Office
2.0%
Volume
46
0%
Source: Thoracic and Cardiovascular Lab
2.0%
1.5%
2014
3%
9%
16%
80%
60%
40%
73%
20%
0%
Hiatal Hernia and GERD
Lung Surgery
UVA 30-Day Mortality (%)
2013
Achalasia
Diverticulum
Other
Source: UVA Heart and Vascular Center Quality Office
Atrial Fibrillation Correction Surgery | 2012–2014
(n = 250)
29
20%
Source: UVA Heart and Vascular Center Quality Office
0%
Hiatal Hernia and GERD
Arrhythmia Surgery
Lung Surgery
UVA 30-Day Mortality (%)
2.0%
1.5%
1.0%
0.5%
■■
0.0%
L eader in developing surgical approaches for atrial
fibrillation and ventricular tachycardia
50 surgical procedures performed for arrhythmia
2
management over the past three years, including
2010–2012 invasive,2011–2013
2012–2014
minimally
sternal sparing off-pump
(thorascopic)
and concomitant
UVA 30-Day Mortality
(%)
STSMAZE
30-Dayprocedures
Mortality (%)
The first
theof nation
to3 years.
perform
Note: Year represents
“endinyear”
STS’s rolling
Source: UVA Heart and Vascular Center Quality Office
■■
■■
dual endocardial
and epicardial hybrid ablation for atrial fibrillation
(2008)
ne of the national leaders in a clinical trial for
O
concomitant MAZE during valve surgery
Esophageal Surgery
UVA 30-Day Mortality (%)
4.0%
■■
■■
3.0%
2.0%
Atrial Fibrillation Correction Surgery | 2012–2014
(n = 250)
100
80
60
40
20
0
CY 2012
Lone AFIB Ablation
Regional center for complex laser lead extractions
ybrid procedure with cardiac surgeons and
H
electrophysiologists working in tandem to maximize
patient safety, while minimizing risk of complications
2010–2012
2011–2013
2012–2014
ardiothoracic Surgical Trials Network Afib rate
C
UVA 30-Day Mortality (%)
STS 30-Day Mortality (%)
vs. rhythm trial for atrial fibrillation or flutter after
cardiac“end
surgery
Note: Year represents
year” of STS’s rolling 3 years.
Source: UVA Heart and Vascular Center Quality Office
■■
Concomitant AFIB Ablation
120
100
80
60
UVA is one of the only medical centers in Virginia
offering three minimally invasive options for
occluding the left atrial appendage (LAA).
■■
20
■■
■■
CY 2014
Source: UVA Heart and Vascular Center Quality Office
40
CLINICAL TRIAL HIGHLIGHTS
CY 2013
STROKE RISKS
1.0%
0.0%
REVAIL trial, a continued-access protocol study of
P
the Watchman™ device, now FDA approved
articipated in the AtriClip®®®/stroke trial for left atrial
P
appendage occlusion and was the lead enrolling site
0
he LAA is the source of clots that can cause
T
the majority of strokes in atrial fibrillation
patients after heart surgery.
2012
y occluding
B
the LAA, 2013
physicians could 2014
eliminate
the needLab
for patient to take blood
Source: Thoracic
and Cardiovascular
thinners.
■■
“With expertise with each of these procedures, our
left atrial appendage team decides together the
optimal approach for each individual patient.”
– Gorav Ailawadi, MD, UVA Cardiothoracic Surgeon
For more information:
uvaphysicianresource.com/watchmansfdaapproval-gives-atrial-fibrillation-patientsfurther protection-from-stroke/
30
Other
Cardiovascular
Publications
MINIMALLYThoracic
INVASIVE
OPTIONS TO REDUCE
LEAD EXTRACTION
5.0%
Diverticulum
Source: UVA Heart and Vascular Center Quality Office
UVA offers comprehensive and aggressive
treatment strategies for patients with refractory
atrial fibrillation.
■■
Achalasia
Advancing Knowledge
Leaders in research, dedicated
to defining the future.
As a member of the Cardiothoracic Surgical Trials
Network, UVA has taken a lead role in improving the
surgical treatment for cardiovascular disease.
■■
■■
ACADEMIC PUBLICATIONS AND
NATIONAL PROMINENCE:
Cardiac Surgery, Cardiovascular Medicine
& Vascular Surgery
175
esignated as 1 of 10 core clinical center for
D
Cardiothoracic Clinical trials by the National Institutes
of Health.
linical trials enable us to offer patients options not
C
yet available at other centers.
35
IRB protocols underway for
retrospective medical records reviews
14
Actively recruiting prospective
interventional clinical trials
4
Trials within start-up phase
5
Trials with patients in follow-up
Source: Surgical Therapeutic Advancement Center Office
■■
■■
■■
■■
John Kern, MD – Mitroflow Aortic Valve trial (Sorin)
■■
National Institute of Health (NIH) CT Surgery Network
– Irving Kron, MD
■■
Books or book chapters
listed in authorship
73
Study sections or national committees
65
Memberships on editorial boards,
past and present
PUBLICATION HIGHLIGHTS
National principal investigator (PI) for multicenter,
industry-sponsored clinical trials
ilbert R. Upchurch Jr., MD – Endurant EVO AAA
G
stent trial (Medtronic)
19
Source: UVA Department of Surgery
RESEARCH HIGHLIGHTS
■■
Articles in peer-reviewed journal
listed in authorship
orav Ailawadi, MD, and Sandra Burks, RN:
G
“Costs Associated with Health-Care Associated
Infections in Cardiac Surgery” – Journal of the
American College of Cardiology
I rving Kron, MD, and Gorav Ailawadi, MD:
“Predicting Recurrent Mitral Regurgitation After
Mitral Valve Repair for Severe Ischemic Mitral
Regurgitation” – The Journal of Thoracic and
Cardiovascular Surgery
I rving Kron, MD, and Gorav Ailawadi, MD:
“Surgical Treatment of Moderate Ischemic Mitral
Regurgitation” – New England Journal of Medicine
orav Ailawadi, MD: “Surgical Ablation of
G
Atrial Fibrillation During Mitral Valve Surgery”
– New England Journal of Medicine
First site with IRB approval
– LVAD stem cell trial: First center to enroll
– Neuroprotection trial
31
Recognition & Leadership
2015 AWARD RECIPIENTS
Nationally recognized
for innovation and
dedication to advancing
cardiovascular care
Irving Kron, MD
Earl Bakken Scientific Achievement Award
Society of Thoracic Surgeons Annual Meeting
Recognizes outstanding scientific contribution
in cardiothoracic surgery
Benjamin Kozower, MD
Richard E. Clark Award
Society of Thoracic Surgeons Annual Meeting
Outstanding STS database paper
Damien LaPar, MD
Benson R. Wilcox Award
Thoracic Surgery Directors Association Award
Society of Thoracic Surgeons Annual Meeting
Faculty mentor: Gorav Ailawadi, MD
Best scientific abstract submitted by a
cardiothoracic surgery resident
David Strider, ACNP
Excellence in Clinical Practice Award
Society of Vascular Nursing
Kenan Yount, MD
President’s Award
Society of Thoracic Surgeons Annual Meeting
Faculty mentor: Gorav Ailawadi, MD
Best scientific abstract by resident
or young investigator
2014 AWARD RECIPIENTS
James Gangemi, MD
Dean’s Award for Clinical Excellence
John Kern, MD
Socrates Award
Society of Thoracic Surgeons Annual Meeting
For outstanding commitment to resident education
and mentorship
Curtis Tribble, MD
Inspiration Award
Southern Thoracic Surgical Association Annual Meeting
In recognition of exceptional efforts in motivating, inspiring
and cultivating the clinical and research talents of upcoming
generations of cardiothoracic surgeons
32
NATIONAL AND REGIONAL LEADERS
Gorav Ailawadi, MD
Cardiac Chair, Society of Thoracic Surgeons
Tech-Con Annual Meeting
Research Chair, Virginia Cardiac Surgery
Quality Initiative
James Gangemi, MD
Program Committee, Society of Thoracic Surgeons
Faculty Instructor, TRSA Boot Camp
John Kern, MD
Deputy Editor, Annals of Thoracic Surgery
Associate Editor, Operation Technique in
Thoracic and Cardiovascular Surgery
Damien LaPar, MD
Society of Thoracic Surgeons Board of Directors,
Resident Director
Immediate Past President, TSRA
Research and Writing Committee Member,
Virginia Cardiac Surgery Quality Initiative
Benjamin Kozower, MD
Chair, Society of Thoracic Surgeons General
Thoracic Database Task Force
Associate Editor, Operation Technique in
Thoracic and Cardiovascular Surgery
Christine Lau, MD
Research Scholarship Committee,
American Association for Thoracic Surgery
William Robinson, MD
Co-Chair, “Top Gun” Residents and Fellows
Simulation Program, Society of Clinical Vascular
Surgery Annual Meeting
Society of Vascular Surgery Quality and
Performance Measures Committee
Margaret Tracci, MD
Reviewer: Journal of Vascular Surgery,
Annals of Vascular Surgery, CardioVascular and
Interventional Radiology
President-Elect, Virginia Vascular Society
Chapter Delegate, Medical Society of Virginia
Curtis Tribble, MD
Committee on Resident Education, American
College of Surgeons
Membership Committee, Southern Thoracic
Surgical Association
Gilbert R. Upchurch Jr., MD
Secretary/Treasurer, Virginia Vascular Society
Advisory Council for Vascular Surgery,
American College of Surgeons
Chair, Publications Committee, Society for
Vascular Surgery
Editorial Board: Annals of Vascular Surgery,
Journal of the American College of Surgeons,
Journal of Endovascular Therapy, AORTA, JAMA
Surgery
Scientific Affairs and Government Relations
Committee, American Association for
Thoracic Surgery
Centennial Committee, American Association
for Thoracic Surgery
Curriculum Editor, Joint Council on Thoracic
Surgery Education, Cardiothoracic
Counselor, Southern Thoracic Surgical Association
Past President, Virginia Surgical Society
33
UVA Cardiovascular and Thoracic Surgeons
GORAV AILAWADI, MD
JAMES ISBELL, MD
Adult Cardiovascular Surgery
Adult Cardiac Transplant
434.924.5052
[email protected]
Thoracic and General Surgery
Lung Transplant
434.243.6443
[email protected]
KENNETH CHERRY, MD
Vascular and Endovascular Surgery
434.243.7052
[email protected]
JAMES GANGEMI, MD
34
JOHN KERN, MD
Cardiothoracic and Vascular Surgery
Adult Cardiac Transplant
434.982.4301
[email protected]
Adult and Pediatric
Congenital Heart Surgery
Pediatric Cardiac Transplantation
434.243.6828
[email protected]
BENJAMIN KOZOWER, MD
RAVI GHANTA, MD
IRVING KRON, MD
Adult Cardiovascular Surgery
Adult Cardiac Transplant
434.924.5052
[email protected]
Cardiothoracic and Vascular Surgery
Adult Cardiac Transplant
434.924.2158
[email protected]
Thoracic and General Surgery
Lung Transplant
434.924.2145
[email protected]
CHRISTINE LAU, MD
Thoracic and General Surgery
Lung Transplant
434.924.8016
[email protected]
CURTIS TRIBBLE, MD
WILLIAM ROBINSON, MD
GILBERT R. UPCHURCH JR., MD
Vascular and Endovascular Surgery
434.243.9250
[email protected]
Vascular and Endovascular Surgery
434.243.6333
[email protected]
MARK ROESER, MD
Adult and Pediatric
Congenital Heart Surgery
Pediatric Cardiac Transplantation
434.243.6828
[email protected]
Thoracic and Cardiovascular Surgery
434.243.4301
[email protected]
LEORA YARBORO, MD
Adult Cardiovascular Surgery
Adult Cardiac Transplant
434.243.6828
[email protected]
MARGARET TRACCI, MD, JD
Vascular and Endovascular Surgery
434.243.9493
[email protected]
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Physician Resource
UVA Health System news and information
for our referring physicians
uvaphysicianresource.com
©
MyChart
Provides patients with secure online access
to their information, enabling interaction and
communication with our surgeons and staff
mychartuva.com
EpicCare Link
Online portal that allows providers secure
access to view their patients’ charts at UVA.
To sign up, contact :
Amy Cash
Physician Relations
434.465.7996
[email protected]
Request Visit
Our physicians are available to visit you in your
office and provide more indepth information on
our procedures and services.
To request a visit, contact :
Amy Cash
Physician Relations
434.465.7996
[email protected]
36
Refer a Patient
800.552.3723
Transfer a Patient
844.933.7882
Refer a patient: 800.552.3723
Transfer a patient: 844.933.7882
heart.uvahealth.com